198008545-5-10-2022-54-CC-RDEO-CEAVDB-20220510162029

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198008545
Report Date: 05/10/2022
Date Signed: 05/10/2022 04:20:39 PM

Document Has Been Signed on 05/10/2022 04:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ALLEN-WILLIAMS FAMILY CHILD CARE		FACILITY NUMBER:	198008545
ADMINISTRATOR:	ALLEN-WILLIAMS,KATRINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 630-6100
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 5	DATE:	05/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Licensee - Katrina Allen-Williams		TIME COMPLETED:	04:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) R. Derraco conducted an unannounced required one year inspection to the above facility on 05/10/22. LPA arrived at the facility at 02:30 PM and met with Licensee, Katrina Allen-Williams, who guided analyst on a tour of the facility. Per Licensee, there are 14 children that are currently enrolled. There were 5 children present upon arrival. This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, a den, laundry room, attached garage, front yard and backyard (fenced). The off limit areas include 2 bedrooms, one bathroom, garage, and front yard. The main care area is located in the living room. LPA observed several sensory toys, art materials, storage cabinets for children, a wall mounted television, child sized table and child sized chairs. LPA observed a Graco pack and play in the den along with 5 theater style chairs, two wall mounted televisions, a desk and a infant changing station. LPA did not observed any sharp objects accessible to children in care in the kitchen area. Locks were observed beneath the sink and beneath the stove. The laundry room was observed to be clean and free of defects. No detergents or cleaning materials were observed to be accessible to children in care in the laundry room. A fire extinguisher with a service tag dated 06/28/21 was observed in the laundry room and is fully charged. A Jack and Jill style bathroom was observed to also be clean and free of defects. A doorway leading into bedroom one from the bathroom was observed. Additional age appropriate toys, art materials and a cubby locker were observed in bedroom one. LPA observed sleeping cots to be stored in the closet of bedroom one. A door leading from bedroom one into the hallway was observed. LPA observed required postings in the hallway and through out the facility. The backyard play area was observed with tri-cycles, outdoor play equipment and a tether ball pole. Shade is provided by an awning and floor cushioning is provided by artificial grass. LPA advised licensee that a swarm of bees were observed on the side of the backyard play area. Licensee states she did not know and agreed to have bees removed. LPA advised that (page 1 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ALLEN-WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198008545
	VISIT DATE: 05/10/2022

NARRATIVE

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children should not be allowed to play in backyard play area until issue is resolved. LPA observed that there are two fireplaces in the living room and den that is screened, locked and inaccessible. The licensee states that she provides food for children in care. Per licensee, isolation area for children showing signs of illness will be located in bedroom one. Smoke and carbon monoxide detectors were tested and are operable. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. There are no pets on the premises. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Individuals who reside in the home were noted and discussed. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Per Licensee, they currently have one assistant. Licensee states that there are no firearms stored in the home

All areas identified on the facility sketch that are accessible for children to use were inspected for safety,

comfort, and cleanliness. There is telephone service via a landline. Per Licensee, the home is equipped with central heating and air conditioning. Per licensee, detergents, cleaning compounds, and other items which could pose a danger to children are kept in the off limits garage.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 01/2024 LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ALLEN-WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198008545
	VISIT DATE: 05/10/2022

NARRATIVE

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records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights provided and report was reviewed with the licensee Katrina Allen-Williams

(page 3 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC809 (FAS) - (06/04)

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